Essential tremor is a condition rather than a disease. It's symptoms are very similar to Parkinson's, a disease about which very little is known, except it's usually less severe.

Some things known about essential tremor are that it's congenital, progressive and chronic, meaning people die with it rather than from it. It most often affects nothing more than the hands, although it can also involve the head, speech and overall balance. The tremor is caused by the inability of the brain to control the electrical impulses that regulate various muscle groups.

I know of two drugs that are used to help tremor--diazipam (Valium) and propranolol. Propranolol is a non-selective beta-blocker used primarily to control hypertension, angina and other heart related conditions and tremor. Valium is an anti-anxiety drug used for mild anxiety and muscle spasms. Both drugs have side effects, of course. Using more than the recommended dosage of propranolol can lead to chemically induced anorexia while long-term use of Valium can lead to drug dependency.

When my initial neurologist noticed that I was losing weight and still had tremor, he recommended I consult another neurologist who worked with a neurosurgeon who, in concert with a biomedical appartus developement company, had become a leader in what's called something like deep implant surgery.

This involves findiing the exact location of the area of the cerebellum, located anterior to the brain stem, that is dysfuntional, and, while very carefully following a non-destructive route from beneath a hole drilled into the top of the skull (closed with a titanium disk) around the brain to the cerebellum, carefully inserting electrodes connected to a wire 'lead' into the appropriate area of the cerebullum.

Throughout this segment of the surgery, the patient is awake and responsive. His/her head is rendered immobile by a metal 'halo,' screwed through the skin of the scalp and forehead and attached to a receptacle in the operating table.

The patient must be awake and responsive in order to allow the neurologist to test the strength of the electrical pulses received by the electrodes. I used the opportunity to ask Dr. Roberts if the surgery meant I'd be able to play the violin. After a two beat silence, his eyes appeared under the drape over my head and he asked, "Do you play the violin now?" "No." I'm sure the team had heard it before, but they all laughed.

Then came the anesthesia--but not before I heard a partial conversation between my neurosurgeon and the doctor from the medical apparatus lab that went something like this: Oh, s**t! What happened?" "I don't know, it just broke." I'm awfully glad I heard no more.

The next step is to push the wire lead under the skin of the neck and the chest to a 'pocket' in the chest wall where a pulse generator is implanted, hook the generator to the lead and close everything up.

Post-op is primarily having your battery levels checked every six months--totally non-invasive.

I've gone through this twice now.

Aren't science and technology wonderful?

Thanks for sharing your story, liz.

It's said that the wire implantation has an extremely high success rate -- how has your surgery been working for you, in terms of regaining function and everyday life?

One of the key differences between Parkinson's tremor and Essential Tremor is that Parkinson's causes a continous tremor at rest which stops on deliberate movement, and the opposite is true with Essential Tremor... at rest there is no tremor at all, but on movement there is a varying degree of shaking or tremor.

People with ET often find that their tremor subsides when they have a few drinks, only to return with a vengence, somewhat worsened, when the alcohol wears off, so alcohol is a very bad recreational substance for sufferers.

It's usually passed down in families, and can be seen in the previous generations leading up to the current person with ET. Since in many cases the tremors don't start till late in life and don't become bothersome or interfere with daily life until one is elderly, in days gone by it was just assumed that tremors were sometimes a natural accompaniment to old age, and not much was done to investigate the cause or find a treatment. You can see this assumption if you watch old movies and tv wear people portray very old people for laughs... they are invariably portrayed with a violent "palsey shake". As late as the 1960's you can see actor Dick Van Dyke doing this for comedy in Mary Poppins. Of course, Van Dyke is now actually that age, and does not have a tremor of his own.

This type of brain surgery has been a godsend in restoring normal function to people who were losing function to Essential Tremor. I hope more vast strides in knowledge will be made in the future, so that this condition and others such as Parkinson's can one day be nullified or even cured.

Helice, I've had mild tremor since I was a teen-ager, which is why I could never work as a waitress. If I tried to serve coffee, for example, more coffee ended up in the saucer than in the cup.

But it is progressive and it did get worse as I grew older, which is why I opted for the surgery.

Btw, my Mother had tremor before me, but not as bad as mine. Beyond that, I don't know. As you say, it was considered a part of the natural process of aging and no one dies from it.

There was a made-for-TV movie a couple of years ago, about a reporter's wife with Parkinson's. She fought and fought--including chemo--and finally became one of the first to go through deep-implant surgery. Surprisingly, my neurologist knew her. Her case was one reason why he chose to specialize in both Parkinson's and essential tremor.

You ask if it's helped. Yes. But I have to qualify that.

I can turn myself on and off (stop snickering, Ray) using an electromagnet. I've made it a habit to turn off at night and on in the morning. When you turn youself on, there's a tingle on whatever side of your body you've turned on. About 13 months after my second surgery--on the right side of my brain, which controls my left side--I felt no such tingle.

I'd had a new battery put in my existing pulse generator, so I could start from scratch. To my dismay, the brand new battery in my right pulse generator was dead. I mentioned this in another thread. After consulting with my doctor, I've opted to wait to replace it until the battery in my left pulse generator starts to fail. Then, I'll have them both replaced, hopefully with rechargeables.

In the meantime, I take my meds and am losing weight again, although I force myself to eat. At least, most of the time, I can eat--even if I have to use both hands to keep things on my fork.

One of my fondest memories is going out to dinner at our favorite steak house (which serves the best Caesar salad with your meal,) after my first surgery, and having my daughter say, "Hey--look at that rock-steady hand!"

This thread was an extremely difficult thing for me to start. I did it because Helice suggested it. I shouldn't have. A person's feelings about possible death shouldn't be turned into an abstract discussion of how that individual was lucky enough to avoid death through chance.

Please take this out of the front page and out of discussion.

I don't understand. Who said anything about being "lucky", or "avoiding death through chance"?

You've made some very confusing statements this past 4:45 AM, lizbeth. Not exactly sure at all what you were talking about.

Can you help me out here?

There is no need to be embarrassed about a tremor Liz, and the thread being viewable by other people might actually help somebody with this condition.

Liz, I tend to agree with Myrddin. Not only will others who have this condition possibly be helped, but your articulation of what you observe of yourself is a huge step for you. Don't stand still and stagnate, Liz, keep taking steps... and be grateful for your challenge(r)s. They are what keep you vital.

To all of you, I'm not embarrassed by my condition. One of our librarians has essential tremor. Her kids say, "Don't mind Mom, her hands always shake."

And I'm not embarrassed by what I say at what is earlier in my time zone than it is in other time zones. Writing the post was difficult for me because of the memories it evoked. I wasn't afraid so much of dying--that's inevitable.tyasaaaaaaaaaaaaaaaaaaaaaa nse dtydsYDDD ty

To continue--without my cat's contribution.

Yes, Helice, my posting was made after my curfew, but--writing the post was difficult for me because of the memories it evoked. I wasn't afraid of dying--that's inevitable. But I didn't want to die through my own possible selfishness.

Any surgery is dangerous. To have people mucking around in your brain is even more so. And to do that 'voluntarily' could be viewed as insane.

So, of course I had to question myself. Did I know my doctors? Not really. What would happen if the electrodes weren't placed in exactly the right position? Well, for one thing, the surgery wouldn't work. For another, once in place, they cannot be withdrawn. It's a one shot deal.

Then there were the questions about why I was doing this. Was it 'cosmetic?' Was it really important to be able to walk across a room with a full glass of orange juice in one hand? Did it really matter if I had to use both hands to put a forkful of food into my mouth?

It was an agonizing decision and an agonizing time for me--one I don't like to remember. But I made the decision, finally, out of trust--trust in my doctors, in myself and in my God concept.

When it was over, I wanted to know how a very small group of people--four, to be exact--who had made significant contributions to my life, were doing. I had survived and I wanted to thank them.

The second surgery was kind of a piece of cake.

And now I know that I can be a part of my daughter's sometime in the future wedding and that I'll be able to hold any grandchild without being afraid of dropping it.

Tonight, my minor motor muscle skills were bad for no apparent reason--both hands. Fortunately, when I joined Ray's US History Quiz, there were too few of us to continue. I was there just to say hello, however, since I was getting ready to blanch the peas we'd picked yesterday--to salsa music from the workers on the new house next door--in order to freeze them.

Neither my neurologist nor I know why my minor motor muscle skills--like handwriting or keyboarding--can be affected sometimes but not others. I plan to give my brain to science when I die, although I don't know if it'll do much good because of the implants. The insertion of the electrodes may have damaged the areas of the brain that need more study in order to profit science.